Provider Demographics
NPI:1124335674
Name:JUNKINS, SAVANNAH DAWN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MRS
First Name:SAVANNAH
Middle Name:DAWN
Last Name:JUNKINS
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:303 GREEN ST E
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4105
Mailing Address - Country:US
Mailing Address - Phone:252-293-0013
Mailing Address - Fax:252-243-2576
Practice Address - Street 1:162 NC HIGHWAY 33 E
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-8582
Practice Address - Country:US
Practice Address - Phone:252-641-0514
Practice Address - Fax:252-641-1668
Is Sole Proprietor?:No
Enumeration Date:2010-09-04
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02523363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCG461AMedicare PIN